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Protein Enrichment of Donor Breast Milk and Impact on Growth in Very Low Birth Weight Infants

Protein content is often inadequate in donor breast milk (DBM), resulting in poor growth. The use of protein-enriched target-pooled DBM (DBM+) has not been examined. We compared three cohorts of very low birth weight (VLBW) infants, born ≤ 1500 g: DBM cohort receiving > 1-week target-pooled DBM (...

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Autores principales: Fu, Ting Ting, Kaplan, Heather C., Fields, Trayce, Folger, Alonzo T., Gordon, Katelyn, Poindexter, Brenda B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401419/
https://www.ncbi.nlm.nih.gov/pubmed/34445027
http://dx.doi.org/10.3390/nu13082869
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author Fu, Ting Ting
Kaplan, Heather C.
Fields, Trayce
Folger, Alonzo T.
Gordon, Katelyn
Poindexter, Brenda B.
author_facet Fu, Ting Ting
Kaplan, Heather C.
Fields, Trayce
Folger, Alonzo T.
Gordon, Katelyn
Poindexter, Brenda B.
author_sort Fu, Ting Ting
collection PubMed
description Protein content is often inadequate in donor breast milk (DBM), resulting in poor growth. The use of protein-enriched target-pooled DBM (DBM+) has not been examined. We compared three cohorts of very low birth weight (VLBW) infants, born ≤ 1500 g: DBM cohort receiving > 1-week target-pooled DBM (20 kcal/oz), MBM cohort receiving ≤ 1-week DBM, and DBM+ cohort receiving > 1-week DBM+. Infants followed a standardized feeding regimen with additional fortification per clinical discretion. Growth velocities and z-scores were calculated for the first 4 weeks (n = 69 for DBM, 71 for MBM, 70 for DBM+) and at 36 weeks post-menstrual age (n = 58, 64, 59, respectively). In total, 60.8% MBM infants received fortification >24 kcal/oz in the first 30 days vs. 78.3% DBM and 77.1% DBM+. Adjusting for SGA, length velocity was greater with DBM+ than DBM in week 1. Average weight velocity and z-score change were improved with MBM compared to DBM and DBM+, but length z-score decreased similarly across all groups. Incidences of NEC and feeding intolerance were unchanged between eras. Thus, baseline protein enrichment appears safe in stable VLBW infants. Weight gain is greatest with MBM. Linear growth comparable to MBM is achievable with DBM+, though the overall length trajectory remains suboptimal.
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spelling pubmed-84014192021-08-29 Protein Enrichment of Donor Breast Milk and Impact on Growth in Very Low Birth Weight Infants Fu, Ting Ting Kaplan, Heather C. Fields, Trayce Folger, Alonzo T. Gordon, Katelyn Poindexter, Brenda B. Nutrients Article Protein content is often inadequate in donor breast milk (DBM), resulting in poor growth. The use of protein-enriched target-pooled DBM (DBM+) has not been examined. We compared three cohorts of very low birth weight (VLBW) infants, born ≤ 1500 g: DBM cohort receiving > 1-week target-pooled DBM (20 kcal/oz), MBM cohort receiving ≤ 1-week DBM, and DBM+ cohort receiving > 1-week DBM+. Infants followed a standardized feeding regimen with additional fortification per clinical discretion. Growth velocities and z-scores were calculated for the first 4 weeks (n = 69 for DBM, 71 for MBM, 70 for DBM+) and at 36 weeks post-menstrual age (n = 58, 64, 59, respectively). In total, 60.8% MBM infants received fortification >24 kcal/oz in the first 30 days vs. 78.3% DBM and 77.1% DBM+. Adjusting for SGA, length velocity was greater with DBM+ than DBM in week 1. Average weight velocity and z-score change were improved with MBM compared to DBM and DBM+, but length z-score decreased similarly across all groups. Incidences of NEC and feeding intolerance were unchanged between eras. Thus, baseline protein enrichment appears safe in stable VLBW infants. Weight gain is greatest with MBM. Linear growth comparable to MBM is achievable with DBM+, though the overall length trajectory remains suboptimal. MDPI 2021-08-20 /pmc/articles/PMC8401419/ /pubmed/34445027 http://dx.doi.org/10.3390/nu13082869 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fu, Ting Ting
Kaplan, Heather C.
Fields, Trayce
Folger, Alonzo T.
Gordon, Katelyn
Poindexter, Brenda B.
Protein Enrichment of Donor Breast Milk and Impact on Growth in Very Low Birth Weight Infants
title Protein Enrichment of Donor Breast Milk and Impact on Growth in Very Low Birth Weight Infants
title_full Protein Enrichment of Donor Breast Milk and Impact on Growth in Very Low Birth Weight Infants
title_fullStr Protein Enrichment of Donor Breast Milk and Impact on Growth in Very Low Birth Weight Infants
title_full_unstemmed Protein Enrichment of Donor Breast Milk and Impact on Growth in Very Low Birth Weight Infants
title_short Protein Enrichment of Donor Breast Milk and Impact on Growth in Very Low Birth Weight Infants
title_sort protein enrichment of donor breast milk and impact on growth in very low birth weight infants
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401419/
https://www.ncbi.nlm.nih.gov/pubmed/34445027
http://dx.doi.org/10.3390/nu13082869
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